Frequently Asked Questions about Periods

What's considered a normal menstrual cycle, and how do I know if mine is irregular?

A normal menstrual cycle ranges from 21 to 35 days, measured from the first day of one period to the first day of your next period. Your actual period should last between 3 and 7 days, with a moderate flow that requires changing a pad or tampon every 2 to 4 hours during your heaviest days.

Your cycle is considered irregular if it varies by more than 9 days from month to month. For example, if your cycle is usually 28 days but suddenly becomes 20 days or 38 days, that’s worth noting. Skipping periods entirely (when you’re not pregnant) also signals irregularity. However, minor variation in cycle length is completely normal and is to be expected.

Teenagers often experience irregular cycles for the first few years after their periods start as their hormones stabilize. Women approaching menopause in their 40s and early 50s also commonly see changes in cycle length and flow as hormone levels naturally fluctuate. However, sudden dramatic changes at any age warrant a conversation with your gynecologist or primary care doctor.

Why are my periods suddenly heavier (or lighter) than usual?

Several factors can cause changes in your menstrual flow, and many are temporary and manageable.

Factors that can impact your menstrual flow include:

• Stress: Whether it’s from work, relationships, or major life changes, stress can throw your hormones off balance and alter your cycle.
• Changes in your weight: Significant weight loss or gain, along with changes in your exercise routine, can also impact your periods.
• Birth control: Starting or stopping birth control often causes temporary flow changes as your body adjusts to different hormone levels. This is normal and usually settles within a few months.
• Medical conditions: Thyroid disorders, polycystic ovary syndrome (PCOS), and uterine fibroids are common causes of flow changes. These conditions are treatable, but they require medical evaluation and management.
• Age: Women in their 40s often notice changes in flow, cycle length, and timing as they approach menopause.

All of these hormone fluctuations are natural, but sudden, dramatic changes should still be discussed with your doctor to rule out other causes and explore treatment options.

Is period pain normal, or could it be something more serious?

Mild to moderate cramping in your lower abdomen and back is completely normal during menstruation. These cramps happen as your uterus contracts to shed its lining, and they typically respond well to over-the-counter pain relievers, heat, or gentle movement.

However, pain that interferes with your daily activities, requires prescription medication, or gets progressively worse over time isn’t something you should accept as “normal.” This level of discomfort warrants medical attention and evaluation by your gynecologist.

Severe pain that starts suddenly or comes with heavy bleeding could signal conditions like endometriosis, ovarian cysts, or fibroids. These conditions are treatable, but they need proper diagnosis and management.

What are some common causes of pelvic pain between periods?

Normal parts of your reproductive cycle can cause pelvic pain between your periods. Ovulation pain occurs mid-cycle when your ovary releases an egg. This pain typically affects one side of your pelvis and lasts anywhere from a few hours to a couple of days. The pain may alternate sides depending on which ovary is releasing an egg that month.

Ovarian cysts are another common cause of pelvic pain. These fluid-filled sacs can cause sharp or dull pain on one side, especially if they rupture or twist. Most ovarian cysts are harmless and resolve on their own, but larger ones may need monitoring.

Sometimes, pelvic pain isn’t pelvic pain at all - it’s pain that stems from your digestive system. Gas, bloating, or constipation can create discomfort in your lower abdomen that mimics gynecological pain.

Urinary tract infections can also cause pelvic discomfort, usually accompanied by burning during urination, frequent urination, or urinary urgency. If you suspect a UTI, visit an urgent care clinic or your primary care doctor for treatment.

Could my heavy periods be causing fatigue or other health issues?

Heavy menstrual bleeding can absolutely cause fatigue and other health problems. When you lose excessive blood each month, your body’s iron stores become depleted faster than they can be replenished, leading to iron deficiency anemia. This condition causes exhaustion, weakness, and pale skin that many women mistakenly attribute to being busy or stressed.

Iron deficiency anemia affects more than just your energy levels. You might notice shortness of breath during normal activities, cold hands and feet even in warm weather, or unusual cravings for ice, starch, or other non-food items. Some women also experience restless leg syndrome or find their hair becoming thin and brittle.

The connection between heavy periods and these symptoms often goes unrecognized because the changes develop gradually over time. You might think feeling tired all the time is just part of your normal routine, especially if your periods have always been heavy.

A simple blood test can check your iron levels and determine if your periods are affecting your overall health. If anemia is detected, treatment options include iron supplements or dietary changes.

What's the difference between PMS and PMDD?

PMS (premenstrual syndrome) and PMDD (premenstrual dysphoric disorder) both occur before your period, but they differ significantly in severity and impact. PMS involves mild to moderate symptoms like mood changes, bloating, breast tenderness, and food cravings in the week leading up to your period. While uncomfortable, PMS symptoms are manageable and don't typically interfere with your daily functioning.

PMDD is much more severe. It causes intense mood symptoms like depression, anxiety, irritability, or anger that significantly impact your daily life and relationships. Women with PMDD might find themselves unable to work effectively, snapping at family members, or feeling completely overwhelmed by emotions they can't control.

The timing also differs. PMDD symptoms are present most of the time during the two weeks before your period starts, then improve dramatically within a few days after menstruation begins. This pattern repeats month after month.

If your premenstrual symptoms interfere with work, school, or relationships, you may have PMDD rather than typical PMS. This condition is treatable with various options, including lifestyle changes, therapy, or medication, so discuss your symptoms with your gynecologist to find the right approach for you.

How can I manage period pain without prescription medications?

Period pain doesn't have to derail your day or force you to rely on strong medications. While some cramping is normal, there are many effective ways to find relief using simple, accessible methods.

• Heat therapy: A heating pad on your lower abdomen, a warm bath, or a hot water bottle can relax cramping muscles and provide significant relief.
• Gentle exercise: Walking or doing light yoga helps increase blood flow and releases natural pain-relieving endorphins. Even a short 10-minute walk can make a difference in how you feel.
• Over-the-counter medications: Anti-inflammatory medications like ibuprofen (Advil, Motrin) work better than acetaminophen (Tylenol) for menstrual cramps because they reduce the inflammation that contributes to cramping. Take them at the first sign of discomfort rather than waiting for pain to become severe.
• Lifestyle choices: Staying well-hydrated, reducing caffeine intake, and getting adequate sleep can help minimize discomfort. Some women also find that limiting salt and increasing magnesium-rich foods like leafy greens and nuts helps reduce cramping and bloating.

The key is finding the combination of methods that works best for you. What helps one woman might not work for another, so don't hesitate to try different approaches until you find your go-to pain management strategy.

When should I see my gynecologist about periods or pelvic pain?

Some period and pelvic pain symptoms require immediate medical attention, while others warrant scheduling an appointment with your gynecologist. Knowing the difference can help you get the right care at the right time.

Schedule an appointment with your gynecologist if:

• Your periods suddenly become much heavier, lighter, longer, or more painful than usual
• Period pain interferes with your daily activities, work, or school despite using over-the-counter pain relievers
• You experience bleeding between periods, after sex, or if your cycle becomes very irregular (varying by more than 9 days)
• You haven't had a period for three months or more (and you're not pregnant), or if periods stop before age 45

Seek emergency care if you experience:

• Sudden, severe pelvic pain that makes it difficult to stand or walk
• Pain accompanied by fever, nausea, vomiting, or heavy bleeding
• Sharp pain on one side, which could indicate a ruptured ovarian cyst or appendicitis
• Any pelvic pain during pregnancy

Trust your instincts. If something feels wrong or different about your body, it’s always better to check with a healthcare provider than to wait and worry.

Understanding your period and recognizing when changes need attention empowers you to take better care of your health. Many women hesitate to discuss period problems, thinking they should just “deal with it” or that pain is simply part of being a woman. The truth is, while some discomfort is normal, severe period problems that disrupt your life aren’t something you have to endure alone.

Regular annual checkups with your gynecologist are important for all women, but don't wait for your yearly visit if you're experiencing concerning symptoms.

At MedHelp Women's and Wellness, we understand that women's health concerns deserve specialized, compassionate care. Dr. Ashley Tamucci, our board-certified gynecologist, offers comprehensive gynecologic services in a comfortable and welcoming environment.